During the Parallel Session, Enabling New Lifestyles, participants gathered to talk about the changing face of public health issues in cities today, and what new solutions are emerging. The panelists drew on their experience working with STD screening, technology for aging in place, and accelerating community health outcomes. In all cases, technology is playing a critical role in public health concerns and solutions, alike.
During the session, a few key characteristics of such technologies emerged:

(1) Provide in-the-moment interventions

Participants saw plenty of ways in which mobile technology, advanced sensors, digital displays, and other digital tools have provided a new opportunity for on-the-spot interventions.

For example, Alexander Börve, an orthopaedic surgeon and creator of iPhone app iDoc24, discussed the proliferation of “hookup” apps that help connect users for casual sex purposes. In high-density urban centers, individuals can publish and browse profiles through a variety of mobile apps — Tinder, Grindr, BangWithFriends, among others — to connect with instant dates, outside of traditional spaces, such as bars and clubs. The shift has interrupted many public health programs ability to provide safe-sex education and intervention, he noted, by removing a specific location where information and access can be provided at the point of contact between potential partners.

Instead of viewing such apps as a problem, however, the group saw opportunities to leverage the popularity and pervasiveness of these apps for encouraging positive behaviors such as STD and HIV testing, providing information about safe sex, and perhaps—in the case of infections such as chlamydia, for which public health officials try to notify partners of infected individuals—improving anonymous data collection and outreach.

Esther Dyson, of EDVenture and HICCUP, discussed the promise of a coordinated public health campaign, that could attempt to provide dozens of interventions into the average community member’s day. Among other ideas, technology tools could be used to provide on-the-spot feedback to program participants and community members about various behaviors — encouraging walking and biking, discouraging elevator use, etc. — through mobile apps, informational displays, and more.

(2) Leverage on-the-ground, non-digital relationships

Technology tools can provide a certain amount of access to community members, helping provide information at just the right moment. But that information needs to be actionable, too.

Participants discussed the need for technology tools to tap into existing networks of physical-world providers and infrastructure—health clinics, transit systems, bike lanes, emergency care, food service providers, property managers, and schools—to ensure that when information is given, it’s connected to programs with funding, resources, and expert knowledge that can provide an intervention that promotes or protect’s the user’s health.

Laura Mitchell, of GrandCare Systems, spoke about the way in which her company’s technology links senior’s personalized care needs, determined by doctors and overseen by medical professionals, with off-the-shelf technology to help seniors age in place. The technology is a critical piece of the puzzle. It helps alert family and providers when something unusual or unexpected happens. But those family and providers are needed to help put real-world plans into action when something is wrong.

(3) Use technology to reduce cost of care

Across the board, many participants were optimistic about the opportunity of technology to provide an inexpensive baseline of care for more people, helping reduce baseline costs and reserving more costly, expert-necessary care of those who actually need it.

For example, Dyson, whose HICCUP campaign doesn’t provide funding to partners, suggested that coordination of existing funding and programs could be tied together. How might that work?

Börve, whose STD Triage app allows users to have a photograph of their genitalia evaluated by experts for possible infections, noted that 69 percent of their users do not have an STD. Despite the high number of infections — 20 million new std infections in the U.S. each year— there is also a large amount of overscreening. At one university health clinic, only 40 of 1,500 students who were screened tested positive. There is a cost for paying for screening services, and the benefits of screening extend beyond just the individual who is treated for a positive result. By using low-cost interventions, like the screening app, clinics and public health officials can focus spending on patients with known cases and on preventive measures.

Similar advantages also exist for elder care, where regular, remote monitoring can help flag potential issues before they become untreatable, and reduce unnecessary doctor visits for routine checkups and screenings.

(4) Address the digital divide

As technology becomes an increasingly important tool for cities to help manage and address public health, it will also be important to ensure that all residents have access to those tools.

Participants discussed some strategies for ensuring fair access for to these new tools, from public WiFi, to text-message based alerts, to encouraging pay-as-you-go packages for Internet access from mainstream providers (which would allow low-use customers, such as seniors and many other potential customers, to access inexpensive important services without subsidizing heavy-bandwidth users).

Several of the participants also discussed the importance of working on age-appropriate interfaces, designed to make technology accessible to users with limited sight or familiarity with technology, when such services are aimed at seniors.

Celeste LeCompte is an independent researcher and journalist, focused on innovation and the environment, based in San Francisco and Guangzhou, China.

At least three of our partner cities in this round of the Living Labs Global Awards are seeking solutions related to transportation. Lavasa, México City, and Guadalajara, each within a developing country, want to find ways to boost alternative transportation and keep infrastructure maintenance ahead of deterioration.

According to the Institute for Transportation & Development Policy (ITDP), by 2030 almost three quarters of the world’s population with reside in cities, with most of that urbanization taking place in developing countries. In order to maintain health and achieve sustainability in the long term, these cities must stay ahead of the game in developing the transportation infrastructure, policies, incentives, and solutions that encourage limited use of fossil fuels.
Several recent concepts are relevant to the challenges faced by these cities. BitCity, a conference on Transportation, data, and technology in cities was held November 4th in New York City. The conference, which will be ongoing, is meant to highlight innovation and expose the barriers currently preventing cities from implementing that innovation. Recorded sessions can be viewed online here.

A second transportation-related tid-bit to come across the radar screen is Mo (short for mobility), which uses smartphone technology with a “bike tag” to link travel data and different modal systems. The idea is to provide users with more choices about how to get around and incentives for making responsible travel decisions. (See the video above.)

Two other mobile apps stood out in a recent scan – Avego’s instant carpool app, Shout and Reroute.it, a mobile web app (works on any smartphone) that compares the cost, travel time, calories burned, and CO2 emitted for several different modes of transportation (e.g. walk, bike, transit, car, or taxi).

Shout is a free mobile app that helps you arrange carpool rides with friends, family, and coworkers in real time. Current “Shout Hotspots” – locations where a critical mass of users has been reached – include Orlando, Florida; Seattle, Washington; Houston, Texas; Bergen, Norway; and Kinsale, Ireland.

Reroute.it was developed by fellows in the Code for America program this summer. It is meant to provide users with full information, and in theory they will use that information to make sustainable, responsible transportation choices. Because it relies on several open data sources, its full features are not available in all locations yet, but it will work everywhere. Seattle and San Francisco are fully featured, with Philadelphia soon to follow.

While some of these solutions may not be appropriate for developing countries’ cities currently, these locations are rapidly adopting mobile technology and present models for how to stay ahead of the curve.

Asklepios Future Hospital Alliance just published our article on health service innovations in cities in their latest magazine issue. The alliance brings together leading global players in healthcare technologies around the Asklepios Future Hospital in Hamburg, where collaborators such as Microsoft and Intel have worked together with one of the world's leading hospital chains to implement the latest in service, process and technology innovations in healthcare. Read our contribution here http://www.asklepios.com/upload/Piloting_Mobile_Health_2782.pdf which features our iDoc24 Showcase as a disruptive innovation in dermatology http://www.livinglabs-global.com/showcase/showcase/206/doctor-in-the-mobile-phone.aspx.